Pulmonary embolism (PE) is a potentially life-threatening cardiovascular condition characterized by the obstruction of one or more pulmonary arteries by a thrombus. The emboli often originate from deep vein thrombosis (DVT) in the legs but can also arise from other sources. The incidence of PE is estimated to be 60-70 cases per 100,000 population annually, with variations based on age, sex, and underlying risk factors. The management of PE has evolved significantly with the introduction of Direct Oral Anticoagulants (DOACs), refined risk stratification tools, and an emphasis on patient-centered care. This lesson provides an in-depth exploration of the diagnosis, risk stratification, and pharmacological management of acute PE, focusing on evidence-based anticoagulation options, dosing considerations, and special populations.